Sorry for the delay in responding to your question but I don't visit this part of the Fool very often.

I am a little skeptical of drugs that are used to "cure" what I perceive to be a mechanical discrepancy.

First of all bruxism is partly due to stress and to discrepancies or interferences in one's occlusion. Either one or any combination of these two factors can lead to the kind of pain that you are apparently experiencing. In my experience I have never seen a case of bruxism that didn't exhibit some sort of occlusal interference or deficiency.

There are three important components to consider when treating an individual's occlusion. One is the conformation of the joint and the surrounding musculature. Nothing can easliy be done to this area. Second is the position of the teeth and how they interdigitate. Generally problems in this area result in sore teeth, but it is not uncommon to have a patient experience muscle spasms or joint pain. And thirdly there is incisal guidance. This factor is (simply put) how much the upper front teeth come over the lower teeth. If the upper front teeth come over the lower teeth enough upon function then the back or posterior teeth will be forced apart and generally no pain or pathology will result. On the other hand dentists frequently see problems with one or more of these three components without the patient exhibiting any symptoms what so ever.

Examine your hard splint to determine if there is what amounts to an incline plane in the front of it that causes your back teeth to clear completely as you move your lower teeth in any direction away from the straight up and down position. If as you move your lower teeth laterally and they continue to contact the splint in the back without the incisal guide in the front forcing the teeth apart, then you should have a new splint made with an adequate incisal guide plane. This solution generally solves most TMJ pain. Of course there are always exceptions.

Now for my disclaimer. This is just an educated guess based upon the information I gleaned from your recent post. I have never seen you as a patient and therefore am unable to give you a more definitive diagnosis. You should be seen in person by a knowledgeable practitioner in order to get an accurate diagnosis.

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